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Get Transaction Report Form - Department Of Labor, Licensing And ... - Dllr Maryland

EE NAME: BUSINESS NAME REG NO. BUSINESS ADDRESS CITY LOCATION OF TRANSACTION (If transaction does not occur at business address). NAME OF PLACE: STATE/ZIP DATE TIME ADDRESS CITY INDIVIDUAL OWNER RESIDENCE SALE STATE/ZIP Principal (Agent) representing owner (Seller) of the items. Provide the Following information: State & Zip Code SELLER'S NAME LAST PHONE NO. CITY STATE DRIVER'S LICENSE NO ( ) ZIP CODE White Afr.Amer. Asian Hispanic OTHER ID: (Two for.

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